Yale Health adds copay to staff plan

The Yale Health plan for faculty, managerial and professional staff will introduce copays for office visits starting Jan. 1, 2019.

The benefit change was announced in emails — the most recent of which was distributed to the groups affected by the change on Nov. 15. According to the November notice, the update will introduce a $20 copay “for office visits, inside and outside the Yale Health Center, for primary care, specialty care, Acute Care, behavioral health/mental health, and physical therapy.” Yale Health will also institute a $20 copay for “regular imaging” like X-rays and a $100 copay “for complex imaging outside the Yale Health Center.”

According to University spokeswoman Karen Peart, designing health care plans requires a balance between costs rooted in the utilization of health care services as well as payroll contributions. Peart said that the new copay is meant to balance these considerations.

She added that Yale is the last of its peers to introduce copays for faculty, managerial and professional staff.

“While copays are a flat amount, Yale has a very progressive salary-based payroll contribution that provides significantly greater university support for lower paid faculty and managerial and professional staff,” Peart said. “The overall value to faculty and staff, particularly at lower salary levels, is among the very best of our Ivy Plus peers.”

According to Howard Forman, professor of radiology and biomedical imaging at the School of Public Health, the introduction of copays might force patients to make more educated decisions when seeking medical care, thereby decreasing unnecessary doctor visits. He added that introducing copays was one of the strategies for Yale Health Plan to “hold down the cost so [they] can be competitive” for faculty and staff.

But he also noted that evidence suggests that when copays are introduced, some patients underutilize health care services that “might be valuable.”

Forman said a group of faculty are upset for the managerial and professional staff, whose salaries are generally lower than those of faculty members and may be more harshly affected by the change.

“Copays do have an impact on care and how people consume care,” he said. “We know they have a disproportionate impact on poorer people by the nature of [them] having less disposable income.”

Mark Schlesinger, a professor at the School of Public Health, also said that the copays would reduce necessary care. He noted that copays especially discourage people from receiving treatment for mental health problems they may face.

He said that “with the exception of the copayments for imaging,” which he felt were appropriate to reduce high levels of unnecessary scans, the changes are “almost without doubt a bad move.”

Julie Krishnaswami, head of research instruction at the Lillian Goldman Law Library at Yale Law School, said her Yale Health Plan has been a blessing and that so far the care has been affordable. But she added that the change will mean a large increase in health care costs especially for those with families and children “who are frequently sick or accident-prone.”

Krishnaswami said that her personal health care costs, as well as those of her colleagues, will increase, which could discourage people from receiving the care they require. She added that the pay raises for her and her fellow managerial and professional staff members do not reflect increases in living costs. As such, she said the heightened health care costs “[feel] like a pay cut.”

“I have a chronic condition and regularly see specialists for treatments,” Krishnaswami said. “I have colleagues with young children who frequently need to be seen for pediatric care. I’ve also heard that colleagues who see mental health professionals are likely to stop.”

Yale Health is located at 55 Lock St.

Carly Wanna | carly.wanna@yale.edu

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